Establishment of nomogram model of delirium after strabismus correction in preschool children
FENG Ying1, JING Jiaona2, WANG Jianshe1, CHEN Lina1
1. Department of Anesthesiology and Surgery, Children's Hospital of Nanjing Medical University, Nanjing 210008, China; 2. Department of Ophthalmology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
Abstract:ObjectiveTo establish the nomogram model of delirium in preschool children after strabismus correction under general anesthesia in order to identify risk factors early and take targeted measures.Methods317 preschool children who were treated with strabismus correction under general anesthesia from January 2021 to October 2021 were selected as the study objects. Delirium and pain were evaluated during the awakening period of the children. Logistic regression was used to analyze the influencing factors of delirium in the awakening period, and R software was used to construct a nomogram model to predict the risk of delirium after strabismus correction under general anesthesia in preschool children.ResultsAmong 317 children, 67(21.1%) had delirium in the awakening period, and were divided into delirium group (n=67) and non delirium group (n=250) according to whether they had postoperative delirium. The univariate results showed that children in the delirium group had higher proportion of aged≤3 years old, the American Association of Anesthesiologists (ASA) grade II, severe pain and longer operation duration than that in the non-delirium group; Logistic regression analysis showed that the age (OR=4.588, 95%CI: 2.401~8.768), ASA grade (OR=4.102, 95%CI: 2.125~7.922) and pain degree (OR=3.589, 95%CI: 2.358~5.463) of preschool children were the risk factors for delirium after strabismus correction. The nomogram was verified, and the calibration curve fit well, and the AUC (95%CI) was 0.841(0.789~0.894), the sensitivity and specificity were 80.80% (95% CI: 75.4%~85.5%) and 71.64% (95% CI: 59.3%~82.0%), respectively .ConclusionThere is a certain risk of delirium in preschool children after strabismus correction. Low age group, higher ASA grade and moderate to severe pain are the risk factors for children to develop delirium in the awakening period. The nomogram model constructed on this basis has a good predictive value for the occurrence of delirium in children during awakening, which suggests that medical personnel need to provide personalized management in the perioperative period of children.